Hurricanes, floods, earthquakes, landslides and volcanic
eruptions—and the devastation they inflict—are all too
familiar to the countries of Latin America and the
Caribbean. In the last decade, natural disasters have caused more
than 45,000 deaths in the region, left 40 million injured or in need
of assistance, and carried a price tag—in direct damage alone—of
more than US$20 billion.1
The health sector has proven particularly vulnerable to such havoc.

This report emanates from the results of a study that examined the impact of HIV/AIDS on the public and private health facilities in South Africa, and outlines the subsystems that are affected. Both public and private sector health facilities have reported an increase in the number of patients seeking clinical care for people living with HIV/AIDS, leading to increased admissions to medical and paediatric wards and increased workloads. This study addresses these issues and makes recommendations for managing the HIV/AIDS case load.
0%ContentsList of Tables...

From corporate boxes to sprinklers, food outlets to toilets, first aid to media, facility and event managers are accountable for the success of sporting ventures and events. Managing Sport Facilities and Major Events explains how to get the job done. With detailed international case studies in each chapter, the book offers a systematic guide to the management issues and practical problems that sports managers must address to ensure financial, sporting and ethical success.

API publications necessarily address problems of a general nature. With respect to particular circumstances, local, state, and federal laws and regulations should be reviewed. API is not undertaking to meet the duties of employers, manufacturers, or suppliers to warn and properly train and equip their employees, and others exposed, concerning health and safety risks and precautions, nor undertaking their obligations under local, state, or federal laws.

Women's involvement in the formal sector has mainly been urban-based, as civil servants in
the health and education sectors, where they had a sizeable presence before the conflict. This
was severely disrupted by the strong restrictions on female employment during the Taliban
period. Currently, close to one-third of all teachers are female, while an estimated 40% of all
basic health facilities lack female staff, a clear constraint to delivering basic services (health, in
particular) to women.

From 1999–2003, FRONTIERS implemented a Global Agenda program of operations research
(OR) projects to address the reproductive health (RH) needs of adolescents in four countries—
Bangladesh, Kenya, Mexico, and Senegal. The project was implemented in urban areas of Saint-
Louis and Louga, in northwestern Senegal, and was called Improving the Reproductive Health of
Youth in Senegal.

A range of factors contributed to this situation, such as the lack of access to basic health
facilities - only 40% of the population is in the coverage areas of basic health facilities, and
only 9% of rural households surveyed in 2003 reported a health facility in their village;1 lack
of female staff at the existing facilities particularly in rural areas; marked rural-urban
disparities in availability of health facilities; and lack of infrastructure (roads and transport)
and security that reduce mobility and access.

Adolescents exposed to the interventions in Site B were more likely to support use of
contraceptives by unmarried adolescents than those in Site A, and a similar pattern was
seen for contraceptive use by married adolescents. Adolescents who were exposed to the
intervention showed more favorable attitudes regarding use of condoms by unmarried
adolescents than the non-exposed in both Site A and B. The analysis also revealed a
more positive attitude towards health facilities for contraceptive and STI services
compared with pharmacies as a source of supplies and services.

Both Planned Parenthood and the alternative sites we interviewed typically had
relationships with other local health care providers. Thus, changes that affect one set of clinics,
like Planned Parenthood, may have repercussions for other providers in the communities. Clinics
often refer patients for care at other facilities if they cannot provide the services themselves. For
example, if a woman is diagnosed with diabetes in a WHP exam at a family planning clinic, she
would be referred to a community health center or public primary care clinic for further follow-
up and care.

Perceived quality of care is an important factor that determines whether people choose to utilise
SRH services. Evidence from Bangladesh, Senegal and Tanzania suggests that in areas where
women felt that they were receiving a high standard of care, they were more likely to use
contraceptives than in areas with lower quality health facilities.
Improving quality of care requires that patients’ perspectives and levels of satisfaction are taken
into account when evaluating services, and are incorporated into policy decisions.

When small, independent providers want to
negotiate with multiple health plans, large
insurers exert enormous pressure to stop them.
The statewide trade group for doctors in New
York sued UnitedHealth Group Inc., the nation’s
second-largest health insurer by enrollment, for
allegedly using illegal coercion in just such a
scheme to limit competition.26
In a separate matter UnitedHealth agreed to pay
$400 million to settle multiple suits alleging
price fixing and other anti-competitive
behavior.

Pathfinder has developed a two-way referral system for infections and serious complications. CHWs send
clients to nearby health facilities with a referral note, which helps ensure that people living with HIV/AIDS are
seen promptly and free-of-charge. In some cases, if the client is too weak to travel alone and has no family to
accompany him, or is afraid of the stigma associated with being HIV-positive, the CHW escorts the client to
the health facility.

The magnitude of this relationship has important policy implications. If there is a
positive effect of mother’s education as knowledge on children’s health, certain type of
policies concerning the diffusion of speciﬁc information at community levels can be
called for. For example, one important channel through which mother’s education as
knowledge can affect child’s health at a community level is through the usage of health
facilities which can serve as a complement or even as a substitute for the mother’s
education.

The empirical literature on human capital investment generally focuses on education and
health investments using reduced form models that integrate the health production
process with a model of household choice. The demand studies for health outcomes
usually evaluate the impact that household and community level characteristics, like the
usage and availability of health facilities, may have on distinct health measures.

Other donors also work across the public health spectrum. AusAID has a substantial, broad health portfolio including programs in MCH, HIV/AIDS, pandemic influenza and health systems strengthening, which focuses on financing and human resources. AusAID and USAID work particularly closely and collaboratively to ensure effective coordination and complementarity of efforts. JICA has a broad health portfolio that complements the GHI, including programs in MCH, pandemic influenza, TB, rational drug use and vaccine production.